Cosmetic Acupuncture for Acne vulgaris Treatment,I discuss three types of acne below. I have described the acne as I see it, and the analysis and treatment are according to these symptoms. Again, there may be several more manifestations of acne and many mixed types.
Pathophysiology of acne – a Western medical concept
● Increased production of sebum, manifested as greasy skin.
● Proliferation of commensal bacteria, in part connected with increased production of sebum.
● Blockage of the follicular opening due to hyperkeratosis of epithelium in the follicular canal, which is the basis for comedone formation.
● An infl ammatory reaction to commensal bacteria and hyperkeratosis.
● In women, increased androgen values may be relevant, especially in association with polycystic ovary disease.
Acne vulgaris manifests as large deep-red pimples with yellow heads. It affects predominantly the face but also the neck, décolleté and upper back.
The pimples become darker after the pustules heal and form deep scars which remain, making the skin seem quite uneven. Post-inflammatory scarring, keloid scarring and pigmentation can last for over a year. The condition is common in teenagers and is often worsened by their diet of refined sugars and milk products, but it is also seen in adults (Figure 6.3).
Acne vulgaris – traditional Chinese medicine view
● Thick oily skin – dampness in Lung (and Spleen).
● Deep scars which remain after healing, making skin very uneven – signifi es yin defi ciency and the fl uid being too thick.
● Poor elimination of skin – Lung (and LI) Qi defi ciency.
● Infl ammation – Lung yang excess
■ Cool the heat – Sp 10 or UB 17.
■ Disperse heat – Lu 5 venous bleeding.
■ Avoid dairy products and refined sugars to counter dampness.
■ Treat twice weekly for 12 sessions.
■ The highlight of the treatment is the local points on the areas of the acne.
I use 15 mm needles of a 0.20 mm gauge for this. With the patient lying down, place many short needles subcutaneously at the areas where the acne is prevalent. The needles should be given just deep enough to stand, and not fall against the skin. The needles are given in the normal skin, not into the inflamed area. There can be up to 15 needles on the face. Leave the needles for 20 minutes, along with the other acupuncture points on the body.
No needle technique is used and no De Qi is obtained. This local needling causes the maximum effect on the acne, where the skin clears after each
treatment. The patients love the effect, and never complain about the pain.
The results are due to the fact that the local needling causes increased blood flow and circulation in the area.
The primary problem in acne vulgaris is the thick and oily skin and an increased sebum production from the sebaceous glands. This is worsened
by a faulty diet which is very damp-producing – refined sugars, milk products, oily foods and eating large meals in the evenings. The dampness originates in the Spleen, and affects the lungs and skin. The points Sp 9 and St 40 will help this. Patients should be given strict instructions on what to avoid in their diet. If they follow the advice when treatment begins, they will see a great improvement, and this will keep them motivated. If at any time they return to their poor eating habits, they will see the skin immediately worsen. Often, patients ask us how long the effects of the treatment will remain. We can tell them that it will be good for as long as they take care of their diet!
There are many of us who have oily skin but without acne. Problems begin when the skin does not eliminate the sebaceous secretions well, and these stay under the skin and create stagnation of dampness. There could be two reasons for the problem:
■ The Lung Qi is deficient, and the skin has poor opening and eliminating functions, so the dampness cannot get out.
■ The thick fluid of the sebaceous secretion has less thin fluid – yin deficiency – and therefore the fluid gets even thicker and this makes the circulation and elimination of the fluid more difficult. This also affects the healing process, and the scars remain deep long after the pustules have healed.
The treatment for the first reason is to improve elimination. It would be interesting to note that many patients with poor have problems with constipation. Treat the constipation, and the skin improves its elimination function. Hence the points LI 4 (the great eliminator), St 25 and TW 6 are used. Also, tapping with the plum-blossom hammer along the para-vertebral line from level of L 4 to S 4 until there is a red skin reaction will help with activating the bowels. For the skin itself, points UB 13 and LI 11 will help to activate the Qi.elimination of skin also have problems with constipation. Treat the constipation, and the skin
improves its elimination function. Hence the points LI 4 (the great eliminator), St 25 and TW 6 are used. Also, tapping with the plum-blossom hammer along the para-vertebral line from level of L 4 to S 4 until there is a red skin reaction will help with activating the bowels. For the skin itself, points UB 13 and LI 11 will help to activate the Qi.
Advice for patients
Good skin hygiene is crucial in the treatment of acne. Many patients use extra make-up to cover the acne but do not remove it thoroughly. This blocks the pores and worsens the situation. We should advise patients to clean and steam the face morning and night, and to use a light moisturizer afterwards. A facial sauna is also a good idea.
The treatment for the second reason is to tonify yin. Patients should drink water (ideally warm) throughout the day. This would thin out the thick damp fluid of the sebaceous secretions, and improve its circulation and elimination movement. Point Lu 1 will also help to thin the sebaceous secretions.
Cooling the heat or treatment of the inflammation is done with point Sp 10 or with UB 17, both of which are excellent points against any surface irritation or inflammation. However, if a large extent of the skin is affected, venous bleeding on point Lu 5 can be used once or twice.
Take note: many patients with acne vulgaris take long-term oral antibiotic treatment. The skin flares up very badly when they stop this for the acupuncture treatment. Unfortunately, these patients are not good subjects for acupuncture as we seem to be working on them at the worst possible moment. We would be wasting the precious first few treatments on them, when the body has a poor response. It would be best if they stop taking the antibiotic, wait a month, and then come for treatment. They could use topical creams during this time to ease the symptoms.
Category: Cosmetic Acupuncture
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